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Disorders of Urinary System Urinary Calculi
Disorders of Urinary System Urinary Calculi
Etiology
Findings
Subjective
Objective
1. diaphoresis
2. vomiting
3. grimacing
4. hematuria, dysuria, pyuria
5. fever
Interventions
1. analgesics as ordered
2. antispasmodics to reduce renal colic
3. allopurinol and allopurinol Na
4. antibiotics to reduce infection
5. fluids – 3000 ml/day
6. diet according to type of renal calculi (kidney stone)
7. strain all urine
1. Calcium Stone
Diet
- low Ca and P diet
- eliminate dairy products
- acid ash diet
- encourage cranberry juice, vegetables, fruits, Vit C
2. Oxalate Stone
Diet
- avoid oxalate rich foods
Diet
- avoid purine rich foods
- alkaline ash diet
4. Cystine Stone
Diet
- limit protein rich foods
- alkaline ash diet
Surgical Intervention
Nursing Care
1. monitor VS
2. fluid intake 3000-4000 ml daily
3. encourage client to monitor diet as ordered
4. encourage weight bearing exercise if not contraindicated
5. change dressings frequently during 1st 24 hours after nephrolithotomy
6. maintain patency of urethral catheter to prevent hydronephrosis
Prevention
Etiology
Findings
Subjective
- irritability
- headache
- anorexia
- tingling of extremities
- lethargy or drowsiness
Objective
- uriniferous breath and perspiration odor
- uremic frost
- anemia
- hypocalcemia
- destruction of RBC, WBC, Platelets
Olliguric Phase
Diuretic Phase
Recovery Phase
- takes 3 to 12 months
- avoid nephrotoxic drugs
Intervention
1. fluid control
2. electrolyte control
3. AB to prevent infection
4. complete bed rest (CBR)
5. peritoneal dialysis and hemodialysis
Nursing Care
1. monitor VS and I/O of fluids
2. promote rest
3. provide skin care
Etiology
Findings
Subjective
1. lethargy, drowsiness
2. headache, nausea, pruritus
Objective
1. oliguria or anuria
2. anemia
3. HPN and Anasarca
4. uremic frost
5. hypocalcemia
6. metabolic acidosis
7. hyperkalemia
8. renal osteodystrophy
9. kussmaul’s respiration
Etiology
1. frequency, urgency
2. difficulty initiating stream
3. feeling of incomplete emptying of bladder
4. nocturia and hematuria
5. decreased force of stream
6. urinary retention
Interventions
Surgical Procedures